As per Parkland formula, the amount of fluid to be infused in the first 8 hours to the patient of 70 kg weight having 50% total body surface area of burn will be

1. A

   8000 mL

2. B

   7000 mL

3. C

   6000 mL

4. D

   5000 mL

Appeared in: ESIC Nursing Officer-7July 2024

Explanation

• The Parkland formula is used to calculate the total fluid needed for a burn patient in the first 24 hours: 4 mL × Body Weight (kg) × %TBSA.
• For a 70 kg patient with 50% TBSA burns, the total 24-hour fluid requirement is 4 × 70 × 50 = 14,000 mL.
• According to the formula's guidelines, half of this total volume must be infused over the first 8 hours.
• Therefore, the amount of fluid for the first 8 hours is 14,000 mL / 2 = 7,000 mL.

Why Other Options Were Wrong

• Option A: 8000 mL is an incorrect calculation. This would be the 8-hour volume if the total 24-hour requirement were 16,000 mL, which does not match the patient's data.
• Option C: 6000 mL is an incorrect calculation. This would be the 8-hour volume if the total 24-hour requirement were 12,000 mL.
• Option D: 5000 mL is an incorrect calculation. This would be the 8-hour volume if the total 24-hour requirement were 10,000 mL.

Related Visual

• Visual 1: Flowchart: A visual flowchart demonstrating the step-by-step calculation using the Parkland formula, from calculating the 24-hour total to dividing it for the 8-hour and 16-hour infusion periods. This helps in understanding the process.
• Visual 2: Diagram: An illustration of the 'Rule of Nines' for adults, which is a common method to quickly estimate the Total Body Surface Area (TBSA) percentage of a burn. This provides context on how the '50%' value in the question is determined.

Clinical Relevance

• Nursing practice connection: Use the key finding related to Parkland formula for burn fluid resuscitation to guide bedside assessment, documentation, and the next nursing action.
• Accurate fluid resuscitation is critical in managing major burns to prevent hypovolemic shock (burn shock) without causing fluid overload.
• Nurses must continuously monitor the patient's response, primarily through urine output, aiming for 0.5–1 mL/kg/hr in adults. The infusion rate is titrated (adjusted) based on this output.
• The 8-hour clock starts from the time of the burn injury, not from the time of hospital arrival. If a patient arrives 2 hours after the burn, the first half of the fluid must be given over the remaining 6 hours.

How to Approach the Question

• Identify that the question is a calculation problem requiring a specific medical formula (Parkland formula).
• Recall or look up the Parkland formula: Total Fluid (24h) = 4 mL × Weight (kg) × %TBSA.
• Extract the necessary values from the question: Weight = 70 kg, %TBSA = 50.
• Substitute the values into the formula to find the total 24-hour fluid volume: 4 × 70 × 50 = 14,000 mL.
• Recall the administration rule: Half of the total volume is given in the first 8 hours.
• Calculate the volume for the first 8 hours by dividing the total volume by 2: 14,000 / 2 = 7,000 mL.

Concept Tested & Keywords

• Concept Tested: Parkland formula for burn fluid resuscitation
• Stem keywords: Parkland formula, fluid, first 8 hours, 70 kg, 50% total body surface area
• Lead-in keywords: amount of fluid

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Qn6xuTFmYkTnQAKcjCPSRI

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